Heretofore, couplers for connecting devices such as an open back hook or screw require the device to be substantially perpendicular to the supporting spinal rod. Such a requirement calls for the surgeon to position a spinal rod in an exact position for proper connection. If the coupler is part of a rod to rod coupler, the spinal rods must be parallel to one another at their connection. This requirement for such an exacting rod position may lead to additional surgery time and may add further complications to an already complex and lengthy procedure to correct a spinal problem.